Hepatocellular carcinoma treated with transarterial chemoembolization: Dynamic perfusion-CT in the assessment of residual tumor

Figure 2 A 57-year-old man with Child B liver cirrhosis and 42 mm lesion of hepatocellular carcinoma in the fourth segment of the liver that underwent computed tomography-perfusion study. A: Transverse data raw multiphasic multidetector computed tomography scan image shows regions of interest (ROIs) positioned on the periphery of lesion (T2), and on the primary lesion without relapse (T1) and on the surrounding liver parenchyma (T3) avoiding vessel structures, in order to obtain the quantitative perfusion data of the regions; B: Functional arterial perfusion colour map shows that the distribution of perfusion in the treated lesion is heterogeneous, with a different range of colours of residual disease (T1) compared with primary lesion without relapse (T2) that reveal the unsuccessful treatment of transarterial chemoembolization; ROIs were also positioned at the same level in surrounding liver parenchyma (T3); C: Post chemoembolization digital fluoroscopic image obtained in the same patient shows disomogeneous distribution of the iodized lipiodol-chemotherapy mixture, with presence of hypervascular region (arrow) at the periphery of treated lesion, demonstrating the viable portion of tumour.